Smartphone Addiction Recovery Coach for Young Adults (SARC-YA) Experiment

摘要 接受药物使用障碍(Sud)治疗的青少年复发率很高。 在他们离开治疗后使用药物。尽管复发预防被广泛地纳入了SUD 对于青少年的治疗，维持康复的手段往往缺乏或不足。智能手机 有潜力通过提供生态瞬时评估(EMA)来满足这一需求；EMA是一种 自我监控干预，可以用来帮助人们识别和更好地理解先行因素， 物质使用的模式和后果。此外，智能手机还可以提供即时访问 通过生态瞬时干预(EMI)提供的一系列恢复支持。 作为P.I.S功勋奖(R37DA011323-14)的一部分，研究团队开发了这款智能手机 青少年成瘾康复教练(SARC-A)移动应用程序，基于动态模型 预防复发，并利用智能手机提供注重康复的干预措施。申请者团队 完成了两项试点研究，在这两项研究中，EMA和EMIS都通过智能手机发送给青少年 分开和合并。结果表明，EMA是可靠的(每天5到6次)和准确的 预测了未来7天的使用风险。此外，参与者平均完成了20个或更多的EMIS 在接下来的7天里，EMI利用率与物质使用量的减少有关。 在这些发现的基础上，申请人提出了以下实验研究。青少年 (n=400)将在他们出院时从4个门诊治疗计划中的1个中随机招募 分配给以下四种情况中的一种：(1)恢复支持正常控制、(2)仅EMA、(3)仅EMI或(4) EMA+EMI实验条件。干预措施将在出院后6个月内每季度提供一次 通过9个月的评估。数据包括标准化评估、尿检、手机元数据、 EMA响应和EMI利用率。研究假设将使用生存分析进行检验，多水平 纵向数据的建模和结构方程建模。这项研究的目的如下： 目标1：测试EMA、EMI和EMA+EMI(v对照)对药物使用频率的影响；目标2： 评估上述影响在多大程度上受到基线物质使用频率的影响；目标3： 检验物质使用频率对EMA、EMI和EMA+EMI影响的程度 康复的其他方面包括SUD症状、艾滋病毒危险行为、生活质量、心理健康、 学校；和目标4：确定EMA反应和EMI利用预测持续时间的程度 禁欲。

Abstract Adolescents who receive treatment for substance use disorders (SUD) have high rates of resuming substance use after they leave treatment. Although relapse prevention is widely incorporated within SUD treatment for adolescents, tools for sustaining recovery are frequently lacking or inadequate. Smartphones have the potential to address this need by delivering Ecological Momentary Assessments (EMA); EMA is a self-monitoring intervention that can be used to help people identify and better understand the antecedents, patterns, and consequences of substance use. In addition, smartphones can provide immediate access to a range of recovery supports delivered via Ecological Momentary Interventions (EMI). As part of the P.I.’s MERIT award (R37 DA011323-14), the research team developed the Smartphone Addiction Recovery Coach for Adolescents (SARC-A) mobile application, which is based on a dynamic model of relapse prevention and utilizes smartphones to deliver recovery-oriented interventions. The applicant team completed two pilot studies in which EMAs and EMIs were delivered to adolescents via smartphones, both separately and combined. Results indicated that EMAs were reliably completed (5 to 6 per day) and accurately predicted the risk of use in the next 7 days. In addition, participants completed an average of 20 or more EMIs per day and EMI utilization was associated with reduced substance use in the next 7 days. Building on these findings, the applicants propose the following experimental study. Adolescents (N=400) will be recruited upon their discharge from 1 of 4 outpatient treatment programs and randomly assigned to 1 of 4 conditions: (1) recovery support as usual control, (2) EMA-only, (3) EMI-only, or (4) EMA+EMI experimental conditions. Interventions will be delivered for 6 months post-discharge with quarterly assessments through 9 months. Data include standardized assessments, urine tests, mobile phone meta data, EMA responses, and EMI utilization. Study hypotheses will be tested using survival analysis, multi-level modeling and structural equation modeling of longitudinal data. The study has the following aims: Aim 1: Test the effects of EMA, EMI, and EMA+EMI (v control) on the frequency of substance use; Aim 2: Evaluate the extent to which the above effects are moderated by baseline substance use frequency; Aim 3: Test the extent to which the frequency of substance use mediates the effects of EMA, EMI, and EMA+EMI on other aspects of recovery including SUD symptoms, HIV risk behavior, quality of life, mental wellness, days of school; and Aim 4: Determine the degree to which EMA responses and EMI utilization predict the duration of abstinence.